A goal underlying all medical implants is to extend the implant life in order to minimize the number of times surgery or other implantation techniques must be performed. For example, in the field of cardiac pacemakers, it is a goal to extend the life of the power source in the pacemaker by minimizing the power requirements of the implant. Furthermore, a pacemaker implant that has a reduced power requirement may utilize a reduced capacity battery to give a lifetime performance of equal duration to pacemaker implants currently available with a physically smaller power source. Both of these goals are directed to reducing the power requirements of the implanted pacemaker electrode as much as possible.
The optimization of the lifetime of a pacemaker implant generally requires a compromise among a number of parameters. For example, it is advantageous to maximize the pacing impedance of the electrode at all times after implant. To accomplish such an increase in the pacing impedance of the electrode, it is necessary to reduce the area of the electrode. This must be done in such a way as to minimize the risk of perforation of the heart tissue and of the chance of dislodgement of an implanted electrode.
Indiscriminately decreasing the size of the electrode tip in order to increase pacing impedance has resulted in some prior art electrodes causing tissue trauma during or following implantation. This result followed from a failure to consider carefully the implications of changes in electrode tip size.
Another significant consideration when designing an electrode tip with optimized performance is the sensing impedance of the electrode tip. The sensing impedance, which should be minimized, increases as the surface are of the electrode tip is decreased. Thus, one of the major problems associated with increasing the pacing impedance by decreasing the surface area of an electrode tip has been the probability of an adverse effect on the sensing impedance.